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I-131 biokinetics of remnant normal thyroid tissue and residual thyroid cancer in patients with differentiated thyroid cancer: comparison between recombinant human TSH administration and thyroid hormone withdrawal

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Abstract

Objective

The aim of this study was to assess I-131 biokinetics in thyroid cancer and remnant tissue in patients with differentiated thyroid cancer using whole-body scan (WBS) and SPECT images acquired after I-131 therapy. The influence of thyroid stimulating hormone (TSH) stimulation method on the kinetics was also evaluated.

Methods

A total of 57 patients who received I-131 therapy (2.96–7.4 GBq) were retrospectively included. TSH stimulation was achieved by recombinant human thyrotropin (rhTSH) or by thyroid hormone withdrawal (THW). Each patient received three sequential WBSs on days 1, 2, and 4 (or 5) after I-131 administration. All lesions were classified either as thyroid remnant (ThyR) or as metastatic lymph nodes (mLN) after considering the SPECT/CT images acquired during the last WBS. The lesion-based retention rate and absorbed dose of ThyR and mLN were calculated using a commercial dosimetric toolkit combined with the OLINDA software.

Results

The retention rate and the effective half-time of mLN were lower than that of ThyR (p < 0.001, p = 0.003). In addition, the retention rate and the effective half-time of ThyR in the rhTSH group were higher than those in the THW group (p < 0.001, p < 0.001). The differences in the retention rate and the effective half-time of mLN were not statistically significant between the THW group and rhTSH group (p = 0.549, p = 0.571).

Conclusions

Radioiodine therapy using rhTSH delivered an at least similar radiation dose to target lesions compared to using THW in thyroid remnants and metastatic lymph nodes.

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Acknowledgements

This work was supported by a National Research Foundation of Korea (NRF) Grant funded by the Korea Government (MSIP) (No. NRF-2015M2A2A7A01045177) and a Grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (Grant Number: HI15C0001). All the authors would like to thank Mr. Yang Joong Kim (MI Application Specialist, GE Healthcare Korea) for his contribution to data acquisition.

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  1. Choon-Young Kim and Chae Moon Hong contributed equally to this article.

Authors and Affiliations

  1. Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea

    Chae Moon Hong, Choon-Young Kim, Seung Hyun Son, Ji-hoon Jung, Chang-Hee Lee, Ju Hye Jeong, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee & Byeong-Cheol Ahn

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  1. Chae Moon Hong
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Correspondence to Byeong-Cheol Ahn.

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Hong, C.M., Kim, CY., Son, S.H. et al. I-131 biokinetics of remnant normal thyroid tissue and residual thyroid cancer in patients with differentiated thyroid cancer: comparison between recombinant human TSH administration and thyroid hormone withdrawal. Ann Nucl Med 31, 582–589 (2017). https://doi.org/10.1007/s12149-017-1188-x

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  • DOI: https://doi.org/10.1007/s12149-017-1188-x

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